SAN ANTONIO, Texas—Duke Realty, an Indianapolis-based healthcare property owner, manager and developer, announced it has bought Christus Santa Rosa Hospital-Alamo Heights in San Antonio and an adjacent medical office building.

Duke announced the transaction two weeks after Christus held an open house and blessing ceremony for the new $25 million facility, which officially opened on Jan. 16. According to a Duke Realty news release, the 36-bed, 57,360-square-foot hospital and the three-story, 53,379-square-foot office building are 100% leased by Christus Santa Rosa Health Care Corp. Duke Realty also purchased three medical office buildings on the Christus St. Catherine Hospital campus in Katy, a western suburb of San Antonio, earlier in January. On Jan. 27, the company also announced that it acquired a four-story, 83,383-square-foot medical office building on the campus of the 77-bed Cedar Park (Texas) Regional Medical Center, which is owned jointly by Community Health Systems and Seton Family of Hospitals.

AUSTIN, Texas—Texas became the ninth state that the Obama administration has denied a temporary waiver of the insurance market requirements in the 2010 healthcare reform law. The state sought a temporary adjustment of the Patient Protection and Affordable Care Act's medical-loss ratio requirement that insurance plans devote a minimum percentage of their budgets to pay for the care of enrollees. Insurance companies must spend between 80% and 85% of premium dollars on medical care or healthcare quality improvement, rather than on overhead costs. Insurance plans that did not meet the requirement in 2011 must begin to provide rebates to their customers in 2012. Texas requested an adjustment of the standard to 71% last year, 74% in 2012 and 77% in 2013. The law allows for waivers if there is a “reasonable likelihood” that adherence to the insurance spending ratio would “destabilize” a state's health insurance market by driving companies out of business or sharply cutting into their profits. “We've seen issuers across the country changing their business practices to meet that standard; practically speaking, this means lower premiums for consumers,” Gary Cohen, acting director of oversight at the CMS' Center for Consumer Information and Insurance Oversight, said in a call with reporters. “This is true in Texas as well.” Six states have had at least part of their waivers approved, and decisions on requests from Wisconsin and North Carolina are expected within the next few months.